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KURT E. KRACAW MD LLC

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Company Details

Name: KURT E. KRACAW MD LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 11 Sep 2017 (8 years ago)
Financial Date End: 30 Sep 2019
Date dissolved: 27 Dec 2019
Entity Number: 570604
Place of Formation: IDAHO
File Number: 570604
ZIP code: 83442
County: Jefferson County
Principal Address: 4649 E 250 N RIGBY, ID 83442
Mailing Address: STE 3 426 FARNSWORTH WAY RIGBY, ID 83442-4713

Agent

Name Role Address
KURT EDWIN KRACAW Agent 4649 E 250 N, RIGBY, ID 83442

National Provider Identifier

NPI Number:
1467963496

Authorized Person:

Name:
DR. KURT EDWIN KRACAW
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2085232025
Fax:
2087459910

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0003717216 2019-12-27
Annual Report 0003370137 2018-12-12
Initial Filing 0000570604 2017-09-11

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Date of last update: 09 Jun 2025

Sources: Idaho Secretary of State